Anyone tried mini IVF for low ovarian reserve?

[SesameSparkle]

Hi, I’m just heading into what is likely be my final IVF attempt and I’m trying to work out if there is anything left to try for someone with very low ovarian reserve. The last 2 goes were natural cycle (modified) and they didn’t work out for me. My fc want to do the same again, but I’d really like to try something aimed at getting more than one egg. Has anyone tried a low stims or mini IVF protocol using clomid, letrozole or tamoxifen? I think these work by increasing the amount of natural fsh produced, to try to recruit more follicles. That sounds appealing, but I’d love to hear from anyone who has tried this out, or is currently considering this.

[SesameSparkle]

Anyone?

[Nan0second]

Not personal experience of natural IVF, but my understanding is very poor success rates for that and mild IVF with low ovarian reserve.
I would recommend a second opinion from a different clinic as short protocol would be more standard advice.
Good luck

[SesameSparkle]

Hi Nan0, thanks for your reply. Yes I know short protocol is a more conventional approach, but I tried that already at another clinic without success. I'm just about at the end of my journey now and I think I'd like to try something unconventional for that final push.

[WootyWoo]

Hi Sesame, all the different names for protocols leave me a bit confused sometimes. I've tried 'flare' protocol with high stims (may also be called short?) and 'natural' ivf with no stim drugs (interested to know what 'natural modified' is?).

I've also tried a Clomid only cycle with the aim to freeze if any made it to blasts (none did unfortunately). You can't have transfer on a Clomid cycle due to the effect Clomid has on lining.

On a natural cycle I only get one egg. When I try for more eggs whether through max stim flare protocol or Clomid 150mg I get the same results - 2/3 eggs. I have low amh so it seems any stims at all produces the same result - this makes me think a mild drug cycle would be better.

None of this is probably very helpful as I've not had success yet! I'm thinking of a mild letozole/menopur combo for my last cycle if we bother at all. In post ivf limbo at the mo trying to decide next steps.
Good luck in your next cycle. Hope you settle on a protocol you're happy with.

[SesameSparkle]

Hi wooty thanks for your comments. I also get hardly any eggs with high stims. I've tried both short flare protocol and a short antagonist in the past. It made sense for me to move to natural cycle as the last couple of short protocols only recovered one egg. But both times I had a follicle on each ovary during stims and I can't help but wonder whether a mild protocol might mean I could try to get 2 eggs instead of one.

Natural modified means taking some drugs a few days into a cycle (typically starting on day 5), to give the clinic a bit more control over the timing of egg collection.

What happens on the protocol with letrozole/menopur that you're thinking of trying?

I know that post ivf limbo well. In some ways I prefer it to the prospect of starting and failing another cycle.... What are the next steps you're thinking about?

[bananafish81]

There are LOTS of women with low ovarian reserve who have had terrific results with mild and natural modified IVF on the low AMH / high FSH boards on Fertility Friends

I am a very low AMH-er but have done well on high stims on a short antagonist protocol (vs short flare), so have no experience of mild stims myself. But loads of women have had femara / menopur, Clomid, mild and natural modified cycles at clinics like Create in the UK, and Serum / Reprofit / Gennet abroad

Worth checking out for lots of advice!

[SesameSparkle]

Hi banana, thanks very much for your comments. I do try to take some inspiration from those who have had greater success from me. Success rates for natural modified in my age group are probably at most 5% - 19 out of 20 attempts will fail. So, as this might very well be my last go at this, I'm keen to explore doing something different if there is anything else out there to try .

[bananafish81]

Sesame - lots of advice and experiences here: www.fertilityfriends.co.uk/forum/index.php?board=535.0

As you know, the thinking behind mild / nat modified is that if you're only going to get 1-2 eggs anyway, there's no point hammering the ovaries with high stims - as a light tap can get better results than a sledgehammer. I've seen a number of posters in their 40s say they got much better quality with mild / nat mod because older eggs can be more fragile.

Serum seem to do a lot of Clomid cycles - which have to be freeze-all because of the impact on the lining

A lovely woman on my cycle buddies thread got her BFP aged 40 from a mild cycle at Reprofit using Femara and a teeny bit of menopur , after having had BFNs from traditional stims cycles

Success rates are low for mild / mini iVF but if you're only going to get 1-2 eggs regardless of the protocol, then quality over quantity any day!

[SesameSparkle]

Thanks very much for the link banana, I have lurked on that bit of ff before, and there is certainly a wealth of interesting stuff. While I do like the hope, I also sometimes also feel a bit down when I compare myself to others too much though - as often the other low AMH'ers seem to be doing much better than me. Going through my mc makes it so much harder - I frequently come across ladies who get pg with a sticky one the cycle after mc. But in my case I just got bfn, or other disasters like failed fertilisation.

However, saying all that I would still like to hear about other's experience of 'mild' treatment, which is what I'm actively considering...?

[WootyWoo]

Hi Sesame I'm not sure what we're doing at the moment, we've just had DH's sperm re-tested and things have changed dramatically which changes everything. We were originally thinking 'oestrogen priming' with mild stimulation to encourage more than 1 egg over natural. Now we are arguing and I'm sleeping on the sofa. Ah the joys of infertility

I hear oestrogen priming is good for poor responders but in my last cycle I started oestrogen priming but my prescription didn't arrive in time for stims. We converted to natural but for the first time in 2 years my right ovary took the lead and the cycle was a bust (no fertilisation). It shouldn't but it's put me off the oestrogen priming, it's only supposed to work with
stimulation after all! We've never had failed fertilisation on my left ovary so I should probably put it down to bad luck (of which we've had plenty ).
It's all a shit fest, sorry not much help. I hope you get some good luck soon x

[SesameSparkle]

Hi Wooty, I'm sorry things sound totally rubbish for you right now. I used to think I had a lucky ovary, as my right was always the one that gives (while the left never seemed to do very much). But my only pg (and mc), I'm convinced was from a left ovary egg, so I'm not sure if that's a real thing now. I also had failed fertilisation on my last natural cycle, yes a bust indeed - at least with a transfer you still get that 2 weeks of hope before bfn.

I had my wtf appointment at my fc today. They've agreed to try a round of mild stims using tamoxifen and low dose menopur. It would be lovely if I could get more than one egg this time. The fc doc thinks that's still pretty unlikely with my history, but he did agree that the outcome with one egg is not likely to be any different from the natural modified I've tried before.

[Joanne55flathead]

Hi im 38yrs old am starting mini ivf next week on clomid at first then something stronger if not many folicals i only have 1 ovary and tube but i had 2 children on that 1 tube 18 years ago and nothing since has anyone had similar and did mild ivf work first time ?

[Mands74]

Hi,
Just been told I have low ovarian reserve, has anyone fallen pregnant with this diagnosis?

[Chattycat78]

I would start your own thread- this is an old one. I'm sure the answer is yes from others. I can also say yes. How low is it? What's your amh?